Wednesday, March 29, 2017
The National Academies Press has released a new book, Strengthening the Workforce to Support Community Living and Participation for Older Adults and Individuals with Disabilities: Proceedings of a Workshop. The book can be downloaded for free as a pdf or purchased as a hard copy .It can also be read online. Here is the description of the publication:
As the demographics of the United States shift toward a population that is made up of an increasing percentage of older adults and people with disabilities, the workforce that supports and enables these individuals is also shifting to meet the demands of this population. For many older adults and people with disabilities, their priorities include maximizing their independence, living in their own homes, and participating in their communities. In order to meet this population’s demands, the workforce is adapting by modifying its training, by determining how to coordinate among the range of different professionals who might play a role in supporting any one older adult or individual with disabilities, and by identifying the ways in which technology might be helpful.
To better understand how the increasing demand for supports and services will affect the nation’s workforce, the National Academies of Sciences, Engineering, and Medicine convened a public workshop in June 2016, in Washington, DC. Participants aimed to identify how the health care workforce can be strengthened to support both community living and community participation for adults with disabilities and older adults. This publication summarizes the presentations and discussions from the workshop.
Tuesday, March 28, 2017
I'd previously blogged about special EMTs that can help avoid trips to the ER for certain folks near the end of life. Kaiser Health News recently ran a story about "pre-hospice": ‘Pre-Hospice’ Saves Money By Keeping People At Home Near The End Of Life. The article explains the problem and one company's solution:
Most aging people would choose to stay home in their last years of life. But for many, it doesn’t work out: They go in and out of hospitals, getting treated for flare-ups of various chronic illnesses. It’s a massive problem that costs the health care system billions of dollars and has galvanized health providers, hospital administrators and policymakers to search for solutions.
Sharp HealthCare, the San Diego health system where [one individual] receives care, has devised a way to fulfill [the patient's] wishes and reduce costs at the same time. It’s a pre-hospice program called Transitions, designed to give elderly patients the care they want at home and keep them out of the hospital.
How does this pre-hospice work? The article explains it. "Social workers and nurses from Sharp regularly visit patients in their homes to explain what they can expect in their final years, help them make end-of-life plans and teach them how to better manage their diseases. Physicians track their health and scrap unnecessary medications. Unlike hospice care, patients don’t need to have a prognosis of six months or less, and they can continue getting curative treatment for their illnesses, not just for symptoms."
The article suggests that the need for pre-hospice programs will only grow in the near future as the Boomers keep growing older and older. But there are obstacles and one in particular is huge. If you guessed money, you'd be right. "[A] huge barrier stands in the way of pre-hospice programs: There is no clear way to pay for them. Health providers typically get paid for office visits and procedures, and hospitals still get reimbursed for patients in their beds. The services provided by home-based palliative care don’t fit that model."
The article discusses the need for and importance of palliative care, other innovations and the catalyst for the pre-hospice program. Delving into the advantages of the pre-hospice program and how it works for patients. The article notes that not only will there be an increased need for programs to keep folks at home, in addition to the payment hurdle, there are "not enough trained providers are available. And some doctors are unfamiliar with the approach, and patients may be reluctant, especially those who haven’t clearly been told they have a terminal diagnosis." And, of course, what will Congress do about health insurance, including Medicare.
Monday, March 27, 2017
Amos Goodall sent me a link to an article he recently wrote, How to plan for end-of-life wishes. Referencing the Conversation Project, Amos writes about how important it is for a client to let others know what the client wants.
These questions boil down to the four Ws:
▪ Who should speak for you when you can’t?
▪ What should they be saying?
▪ When do you want these issues raised?
▪ Where do you want to spend your final time — at home or in a hospital?
Essentially, you need to let folks know how you want to live your life at its end.
After discussing the law, Amos turns back to the Conversation Project and references the toolkit that is available and notes that his firm has adapted some resources for their clients which anyone can access via his firm's website.
According to the project's website, the purpose of the Conversation Project is "to helping people talk about their wishes for end-of-life care." The project offers a 12 page starter kit (available in 8 languages) as well as a 16 page toolkit on choosing and being a health care proxy. There's a 20 page starter kit for those who have a family member or significant other with dementia, including Alzheimer's disease and an 11 page kit for talking to the patient's doctor. There's also one when the patient is your child.
Have you gotten one of these telemarketing calls? You answer, and then a female voice, sounding surprised you answered, makes a comment about her headset and asks if you can hear her. Before you realize this is a robocall, you say yes. Then you realize, it's a recording and you hang up. All's good, right? Maybe not.
The LA Times recently ran a story that explains all of this and what may happen if you say yes. Whatever you do, don’t say yes when this chatbot asks, 'Can you hear me?' calls this scam as the "Can you hear me" scam. "This is a new and highly sophisticated racket known as the “can you hear me” scam, which involves tricking people into saying yes and using that affirmation to sign people up for stuff they didn’t order."
Wait, you say. How can you be signed up for stuff if all you said was yes to the question, can you hear me? The article explains how this spins out
As the scam plays out, the recorded voice will raise the possibility of a vacation or cruise package, or maybe a product warranty. She’ll ask if you could answer a few questions. Or she’ll make it sound like her headset is still giving her trouble and say, “Can you hear me?” ... Don’t say yes.... Police departments nationwide have warned recently that offering an affirmative response can be edited to make it seem you’ve given permission for a purchase or some other transaction. There haven’t been many reports of losses, but a Washington State man reportedly got bilked for about $100.
So don't say yes. But what should you do? If you get one of these (and I have several times), hang up!!! Also, sign up for the do not call list, block the number, screen your calls and check your credit reports. (remember you can get your credit reports free annually).
How is that this robocall is even possible? Technology. As software evolves, this scam will be child's play. According to one expert quoted in the article
[A]s the technology improves and becomes more commonplace, it almost certainly will be embraced by telemarketers and scammers to try to dupe people into thinking they’re speaking with a real person, thus making a questionable sales pitch all the more believable. ... She said machines become more human-sounding the more they can be taught to pepper conversations with the occasional “um” or “uh-huh,” or to laugh at the right moment. They’ll soon convey what sounds like emotion and will adjust their vocal pitch to match the context of the discussion.
The author of the article concludes "[t]ink the “can you hear me” scam sounds devious? Just you wait." Sheesh. I think I'll just quit answering my phone.
Thursday, March 23, 2017
- Over the past 10 years, the population 65 and over increased from 36.6 million in 2005 to 47.8 million in 2015 (a 30% increase) and is projected to more than double to 98 million in 2060.
- Between 2005 and 2015 the population age 60 and over increased 34% from 49.8 million to 66.8 million.
- The 85+ population is projected to triple from 6.3 million in 2015 to 14.6 million in 2040.
- Racial and ethnic minority populations have increased from 6.7 million in 2005 (18% of the older adult population) to 10.6 million in 2015 (22% of older adults) and are projected to increase to 21.1 million in 2030 (28% of older adults).
- The number of Americans aged 45-64 – who will reach 65 over the next two decades – increased by 14.9% between 2005 and 2015.
- About one in every seven, or 14.9%, of the population is an older American.
- Persons reaching age 65 have an average life expectancy of an additional 19.4 years (20.6 years for females and 18 years for males).
- There were 76,974 persons aged 100 or more in 2015 (0.2% of the total 65+ population).
- Older women outnumber older men at 26.7 million older women to 21.1 million older men.
- In 2015, 22% of persons 65+ were members of racial or ethnic minority populations--9% were African-Americans (not Hispanic), 4% were Asian or Pacific Islander (not Hispanic), 0.5% were Native American (not Hispanic), 0.1% were Native Hawaiian/Pacific Islander, (not Hispanic), and 0.7% of persons 65+ identified themselves as being of two or more races. Persons of Hispanic origin (who may be of any race) represented 8% of the older population.
- Older men were much more likely to be married than older women---70% of men, 45% of women. In 2016, 34% older women were widows.
- About 29% (13.6 million) of noninstitutionalized older persons live alone (9.3 million women, 4.3 million men).
- Almost half of older women (46%) age 75+ live alone.
- The median income of older persons in 2015 was $31,372 for males and $18,250 for females. Median money income (after adjusting for inflation) of all households headed by older people increased by 4.3% (which was statistically significant) between 2014 and 2015. Households containing families headed by persons 65+ reported a median income in 2015 of $57,360.
- The major sources of income as reported by older persons in 2014 were Social Security (reported by 84% of older persons), income from assets (reported by 62%), earnings (reported by 29%), private pensions (reported by 37%), and government employee pensions (reported by 16%).
- Social Security constituted 90% or more of the income received by 33% of beneficiaries in 2014 (21% of married couples and 43% of non-married beneficiaries).
- Over 4.2 million older adults (8.8%) were below the poverty level in 2015. This poverty rate is statistically different from the poverty rate in 2014 (10.0%). In 2011, the U.S. Census Bureau also released a new Supplemental Poverty Measure (SPM) which takes into account regional variations in living costs, non-cash benefits received, and non-discretionary expenditures but does not replace the official poverty measure. In 2015, the SPM shows a poverty level for older persons of 13.7% (almost 5 percentage points higher than the official rate of 8.8%). This increase is mainly due to including medical out-of-pocket expenses in the poverty calculations.
*Principal sources of data for the Profile are the U.S. Census Bureau, the National Center for Health Statistics, and the Bureau of Labor Statistics. The Profile incorporates the latest data available but not all items are updated on an annual basis.
Wednesday, March 22, 2017
Are you a Parrot Head? (If you don't know what I mean, the answer to the question is no). Whether you are a Parrot Head or not, wouldn't you love to retire to Margaritaville? Now you can! Jimmy Buffet is opening a chain of 55+ communities within the next year or so. Forbes ran a story last week with the exciting news! Jimmy Buffett To Open String Of Margaritaville Retirement Homes By 2018 explains the plan: "[t]he golden years are looking even brighter with news that Jimmy Buffett is planning to open a string of luxurious Margaritaville retirement home communities, the first in Daytona Beach, Florida. Retirees will be able to live in a paradise where the party never stops and 'growing older, but not up' is encouraged. The price tag will start in the low $200s and furnished models are scheduled to open in early 2018 for those '55 and better.'"
So what will we do if we live in Margaritaville? According to the story "[t]his utopia promises retirees exciting recreation, fitness facilities, lap pools, spas, personal beachfront access, unmatched dining and an entertaining nightlife. Minto Communities has 60 years of experience developing award-winning, master-planned communities and building quality homes for over 80,000 families."
You can read more about this project here .
See you there!
PS-have the song stuck in your head yet?
Justice in Aging has released a new brief on the revised nursing home regulations this one focusing on admissions, A Closer Look at the Revised Nursing Facility Regulations Admission. Here's the executive summary:
The revised regulations broadly prohibit facilities from using admission agreements or other documents that waive a resident’s rights. A resident cannot waive the protections of federal nursing facility law, or protections derived from any state or local nursing facility law. A resident also cannot waive his or her right to Medicare or Medicaid coverage, or any responsibility that the facility may have for the resident’s personal property. A facility cannot obligate a family member or friend to become liable for the nursing facility bill, although the facility can require the resident’s agent to agree to pay the resident’s money for the nursing facility expenses. The revised regulations prohibit pre-dispute arbitration agreements, but this consumer protection currently is blocked by a court order. Prior to admission, a facility must give notice of any special characteristics or service limitations.
The brief concludes with 4 suggestions for advocates and residents: careful review of the contract, sign the contract after residency in the SNF has begun, contest contract paragraphs that are improper and get a lawyer.
Tuesday, March 21, 2017
It's not final, it's not been passed, and changes are likely, but the current health care bill, known as the American Health Care Act, has a significant impact on elders. Last week's CBO report engendered a lot of discussion about the impact of this new health care proposal. The New York Times ran an article last week discussing it, No Magic in How G.O.P. Plan Lowers Premiums: It Pushes Out Older People. The article explains that lower premiums are on the way for some under this proposal. But, the way the lower premiums are achieved? "[T]he way the bill achieves those lower average premiums has little to do with increased choice and competition. It depends, rather, on penalizing older patients and rewarding younger ones. According to the C.B.O. report, the bill would make health insurance so unaffordable for many older Americans that they would simply leave the market and join the ranks of the uninsured."
We know that insurers want to have a broad pool to spread the risk. Typically, "older customers cost substantially more to cover than younger ones because they have more health needs and use their insurance more. By discouraging older people from buying insurance, the plan will lower the average sticker price of care." Ready for some sticker shock? Under the proposal, according to the story, the plan "increases the amount that insurers can charge older customers, and it awards flat subsidies by age, up to an income of $75,000. ... On premiums alone, prices would rise by more than 20 percent for the oldest group of customers. By 2026, the budget office projected, 'premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old — but 20 percent to 25 percent higher for a 64-year-old.'"
The story explains that it's not just the premiums that give the whole picture. Tax credits factor into this as well. Here is where the real sticker shock comes in. "[T]he change in tax credits matters more. The combined difference in how much extra the older customer would have to pay for health insurance is enormous. The C.B.O. estimates that the price an average 64-year-old earning $26,500 would need to pay after using a subsidy would increase from $1,700 under Obamacare to $14,600 under the Republican plan." Did you see that-an increase from $1,700 to $14,600...
The semester is quickly drawing to a close, but the bill could be a basis for an interesting class discussion on social policy, if you have time.
Monday, March 20, 2017
Wonder what is in the new health care bill? New Health Plan Broken Down appears in the Centre Daily Times on March 12, 2017. The article is written by Amos Goodall, a prominent elder law attorney (and graduate of Stetson's LL.M. in Elder Law). The article explains changes to the individual mandate (penalty repealed and replaced), preexisting conditions protection (none), age-based premiums (5:1 ratio & will be up to states which ration), cost-sharing subsidies (will be eliminated), over the counter drugs (adding reimbursement from HSA, FSA or Archer MSA), Medicaid expansion (changes financing) and per capita caps.
To read more about these and other proposed changes, click here.
Thanks to Amos for sending me the link to the story.
Friday, March 17, 2017
I've blogged a couple of times recently about the fight against Alzheimer's disease. Here's a recent story about research efforts stymied by federal law. Big Alzheimer's research roadblock: Federal government was published by CNBC on March 9, 2017. "Promising new research conducted last year at the Salk Institute for Biological Studies has shown that marijuana extracts may hold a key to treating Alzheimer's disease. The next step: To conduct tests on mice and, if the results are promising, move on to human trials. But Salk Institute researchers have run into a major hurdle, and not a scientific one: the federal government. The Salk Institute is based in La Jolla, California — a state that legalized marijuana last November — but it is a federally funded research institute."
The story reminds us that although marijuana use may be legal in several states, it's still not ok at the federal level-it's still a controlled substance. And when a research institute like Salk gets federal dollars for research, there's a problem.
So does this mean a dead end for marijuana/Alzheimer's research? Not necessarily. There is a path, but it won't be a quick or guaranteed one. "In order to acquire marijuana for further studies, the lab must first apply to the Drug Enforcement Agency, which carries out the application process jointly with the U.S. Department of Health and Human Services. The Salk researchers sent in their application in December...." It takes several months for such a request to be approved. The article discusses the costs of Alzheimer's disease (which we have written about in prior posts)
The cost to the economy of caring for Alzheimer's and dementia patients was estimated to be about $236 billion in 2016. In 2015 a study funded by the National Institutes of Health estimated that the costs associated with late-stage dementia are greater than for any other disease.
During the last five years of a person with dementia's life, total health-care spending was more than a quarter of a million dollars per person ($287,038), about 57 percent greater than costs associated with death from other diseases, including cancer ($173,383) and heart disease ($175,136).
We all know how important it is to find an effective treatment (or even cure?) for Alzheimer's. For now, the folks at Salk have to wait to hear if they can move forward.
BTW, those astute readers will notice the url for the story includes the phrase "major buzz kill." To follow up, I'll close now with some my own pithy phrase, "dude, serious bummer". You insert your own pithy phrase here.....
Thursday, March 16, 2017
Today is Call Congress About Medicaid day. Here is the information from the Medicare Rights Center:
Tell Congress to protect our care by joining today’s national call-in day. Urge your representative to vote “no” on the American Health Care Act... Call 866-426-2631 to contact your member of Congress.
The message is to vote no for changes to Medicaid and Medicare. The Medicare Rights Center also offers a one page issue brief on the proposed changes to Medicare, available here.
Regardless of your views, it is always important to make your voice heard.
Thanks to Kim Dayton, the elderlawprof blog founder, for sending me a note on this.
Last week Business Insider ran a story on IBM's plan to track elders. IBM wants to protect senior citizens by tracking nearly their every move explains that IBM has been spending a lot of time on a project to discover how to help boomers continue to be healthy and happy. "That research has zeroed in on outfitting boomers' living spaces with artificially-intelligent sensors that can measure things like air quality, sleep quality, movement patterns, falls, and changes in scent and sound." The data derived, according to the article, can help the kids and doctors "provide people with better care when needed. Critically, the sensors could detect when people deviate from a baseline to offer person-specific alerts."
IBM is ready for beta testing their projects and in fact, the article explains " IBM announced its partnership with Avamere, a senior health care services company. Over the next six months, IBM will use Avamere's assisted living facilities to perform research on prototype sensors... Across three different locations — nursing facilities, assisted living, and independent homes — the sensors will collect data on people's environment and behavior." This is not all that IBM is developing. IBM is also working with Rice University on a robot, known as MERA (or "the IBM Multi-Purpose Eldercare Robot Assistant (MERA), which the company has been testing at its "Aging in Place" lab in Austin, Texas....Sensors can detect when the stove's burners are on, or when a person has fallen down. Even in its prototype stage, MERA is equipped with cameras to read facial expressions, sensors to capture vital signs, and Watson-powered speech recognition to know when to call for help."
But what if mom doesn't want all this monitoring (is anyone besides me thinking about mom's privacy?)? IBM's response-the design will not be obvious and will be a gradual and "[I]f IBM's vision becomes reality, by the mid-21st century, millennials won't be guessing how their parents are faring. They'll have all the data they need, and seniors won't feel as if they're under anyone's care — even if the safety net is sitting right beneath them."
Hal, big brother really is watching!
Thanks to Tom Moran for sending me this article.
Wednesday, March 15, 2017
Yesterday I blogged about the 2017 Alzheimer's Disease Facts & Figures. An article in Huffington Post focused on the impact on Medicare as the Boomers move into that age group where Alzheimer's risk increases. Rising Numbers Of Alzheimer’s Patients Could Bankrupt Medicare offers that
This year, for the first time, total costs related to caring for patients with Alzheimer’s will surpass a quarter of a trillion dollars, according to the Alzheimer’s Association annual report, released Wednesday.
With roughly 75 million boomers only beginning to reach the age of greatest risk for the disease, the U.S. may be disturbingly close to the tipping point for runaway Alzheimer’s-related health care costs. The 88-page report lays out some sobering statistics, including the possible bankruptcy of Medicare.
The article covers dual eligible, the need for funding and research, and some of the proposals from Congress. "Simply put, Alzheimer’s is a public health crisis. Yet due to the social stigma surrounding dementia, its full dimensions are still cloaked in shadow. Combating the disease is going to require that politicians and members of the public speak out and demand real solutions."
Tuesday, March 14, 2017
That is, the term “Alzheimer’s disease” is now used only in those instances that refer to the underlying disease and/or the entire continuum of the disease. The term “Alzheimer’s dementia” is used to describe those in the dementia stage of the continuum. Thus, in most instances where past editions of the report used “Alzheimer’s disease,” the current edition now uses “Alzheimer’s dementia.” The data examined are the same and are comparable across years — only the way of describing the affected population has changed. For example, 2016 Alzheimer’s Disease Facts and Figures reported that 5.4 million individuals in the United States had “Alzheimer’s disease.” The 2017 edition reports that 5.5 million individuals have “Alzheimer’s dementia.” These prevalence estimates are comparable: they both identify the number of individuals who are in the dementia stage of Alzheimer’s disease. The only thing that has changed is the term used to describe their condition.
The report contains a lot of good information that would help our students understand dementia and Alzheimer's. The section on prevalence is sobering. For example, "[a]n estimated 5.5 million Americans of all ages are living with Alzheimer’s dementia in 2017. This number includes an estimated 5.3 million people age 65 and older, and approximately 200,000 individuals under age 65 who have younger-onset Alzheimer’s, though there is greater uncertainty about the younger-onset estimate." (citations omitted). The report also explores the gender, ethnic and racial factors regarding prevalence of Alzheimer's. The report gives a breakdown by state. There is an amazing amount of critical information in this report. The report also includes a special report, Alzheimer's Disease: The Next Frontier.
I'm going to make it assigned reading to my students. Be sure to read this. It's important.
Monday, March 13, 2017
We don't know what the future holds for us, especially in our final years, but we can bet that we may be faced with some health care issues. Wouldn't it be great to have a guidebook for the final years? Well now you can. According to an article in Kaiser Health News, A Playbook For Managing Problems In The Last Chapter Of Your Life, there is "a unique website, www.planyourlifespan.org, which helps older adults plan for predictable problems during what Lindquist calls the “last quarter of life” — roughly, from age 75 on...“Many people plan for retirement,” the energetic physician explained in her office close to Lake Michigan. “They complete a will, assign powers of attorney, pick out a funeral home, and they think they’re done.”...What doesn’t get addressed is how older adults will continue living at home if health-related concerns compromise their independence." The focus isn't on end of life planning, according to the article, it's the time before. "Investigators wanted to know which events might make it difficult for people to remain at home. Seniors named five: being hospitalized, falling, developing dementia, having a spouse fall ill or die, and not being able to keep up their homes."
The result of the work is an interactive website that deals with issues such as falls, hospitalization, dementia, finances and conversations. The website offers that "Plan Your Lifespan will help you learn valuable information and provide you with an easy-to-use tool that you can fill in with your plans, make updates as needed, and easily share it with family and friends." Try it!
Friday, March 10, 2017
We all want a cure for Alzheimer's no question. If not a cure, then a way to prevent it. I blogged twice this week about Alzheimer's so I wanted to add one more story. Newsweek 's cover story for February 24, 2017 focused on prevention of Alzheimer's: The New Offensive on Alzheimer’s Disease: Stop it Before it Starts. The story opens with the news last year that an experimental drug failed to make much of an impact on those in the early stages of the disease. The story focuses on prevention:
This aggressive attempt to prevent Alzheimer’s rather than treating it is the most exciting new development in decades, as well as a radical departure for researchers and the pharmaceutical industry. Traditionally, drug companies have tested their therapies on patients who already have memory loss, trouble thinking and other signs of dementia. It’s been a losing tactic: More than 99 percent of all Alzheimer’s drugs have failed tests in the clinic, and the few that have made it to the market only ameliorate some symptoms. Not a single medicine has been shown to slow the relentless progression of the disease.
But with this new approach, even partial success—an appreciable slowing of brain degeneration—could have a big impact, says Dr. Reisa Sperling, a neurologist who directs the Center for Alzheimer’s Research and Treatment at Boston’s Brigham and Women’s Hospital. If a drug therapy can push back the onslaught of dementia by five or 10 years, she says, “many more people would die of ballroom dancing instead of in nursing homes.”
There are several ongoing clinical trials focusing on prevention, according to the article. There are also new tools to diagnosis Alzheimer's (where in the past, a brain autopsy was needed), We need to hope for a success, because otherwise, as the article points out, the numbers are very very bad:
The consequences of failure could be dire. Approximately 5.4 million Americans suffer from Alzheimer’s, and if no disease-delaying therapies are found soon, that number is expected to nearly triple by 2050, at which point the cost of treating and caring for all those people could top $2 trillion per year, after adjusting for inflation. That’s up from $236 billion today. O ne in every five Medicare dollars is now spent on people with Alzheimer's and other dementias. In 2050, it will be one in every three dollars. And those figures don’t even include the hundreds of billions more in lost wages for family members who take time away from their jobs to care for loved ones. It’s not a question of a day off now and again. People with Alzheimer’s require around-the-clock care—and more than one-third of all dementia caregivers develop clinical depression.
The article also discusses the costs and coverage of any medication that proves successful in preventing Alzheimer's. Stay tuned.
NBC Nightly News ran a story on March 8 about Medicare Observation Status and the Notice Act. Law Aims to Protect Medicare Patients from Surprise Hospital Bill explains the hospital's disclosure requirement for patients and notes that a bill has been introduced to once and for all solve the problems caused when patients are on observation status. "A bill reintroduced Wednesday by Congressman Joe Courtney, D-Connecticut, would make days spent "under observation" count towards qualification for Medicare coverage." The story featured comments from Judy Stein, executive director of the Center for Medicare Advocacy and former NAELA President (full disclosure, I serve of the Center's board).
Thursday, March 9, 2017
You know experience is a good teacher. So imagine getting advice about retirement from someone who is living it? The New York Times ran a wonderful article, From the Elders to the Kids: What I Wish I’d Known. The assignment for a group of "journalism students from five colleges and universities [was] to talk with retirees, and find out what they wish they had known when they were the students’ age." The conversations were recorded and can be viewed on the website. One thing that struck me is that of those individuals featured in the print part of the project retired at a fairly "young" age, ranging between 51 and 67.
Questions included what did the elders wish they had known about retirement when they were the ages of the interviewers, what they wished they had done in preparing for retirement, living a healthy lifestyle, keep active, etc. In one of my classes, I have students interview someone they know who they consider to be an elder. I'm going to include the "what should I know now about preparing for retirement" to the list of questions the students ask. Anyone else assign any similar exercise to their students?
Wednesday, March 8, 2017
When older adults lack the capacity to make important health care decisions for themselves and have nothing in writing naming a person to make decisions for them, how can the right health care decisions be made in clinical settings? Over the past 40 years, nearly every state has passed statutes on health care decision-making. The laws vary from state-to-state, from authorizing living wills or powers of attorney for health care to defining the conditions when withholding or withdrawing life sustaining care is permitted for patients who lack capacity. Despite years of legal guidance, questions remain regarding the statutory applicability in clinical practice. In 2016, the American Bar Association Commission on Law and Aging (ABA COLA) initiated a national survey to explore health care clinicians’ perspectives on questions regarding capacity and decision-making. Findings explore instances when the law and clinical practice clearly align, when there are consultation differences between lawyers and clinical providers, and outline the areas that still present the greatest challenges for health care decision making in clinical settings.
In this webinar, David Godfrey, Senior Attorney to the ABA COLA, will detail the survey findings and implications for the health and aging network working with older adults with diminished capacity. The webinar will be accompanied by an Issue Brief that highlights the survey findings and provides recommendations for the field.
To register for this free webinar, click here.
The teachers' pension fund in Puerto Rico is the latest example of an under-funded government-operated retirement plan. A unique complication of the Puerto Rico teachers' plan is the decision to opt out of Social Security as a separate form of retirement income. In a recent New York Times article, the reporter makes the the analogy to a Ponzi scheme:
Puerto Rico, where the money to pay teachers’ pensions is expected to run out next year, has become a particularly extreme example of a problem facing states including Illinois, New Jersey and Pennsylvania: As teachers’ pension costs keep rising, young teachers are being squeezed — sometimes hard. One study found that more than three-fourths of all American teachers hired at age 25 will end up paying more into pension plans than they ever get back.
“I think they’re really being taken advantage of,” said Richard W. Johnson of the Urban Institute, a co-author of the research. “What’s so tragic about this is, often the new hires aren’t aware that they’re getting such a bad deal.”
The problem is magnified by the fact that the Puerto Rico teachers union — like many teachers and police unions around the country — opted out of Social Security long ago, hoping it could save both workers and the government money by not paying Social Security taxes.
That decision was predicated on the assurance that the workers’ pensions would be well managed and adequately funded. But in Puerto Rico, as in some other places, that has not been true for decades.
For more, read In Puerto Rico, Teachers' Pension Fund Works Like a Ponzi Scheme.